[Congressional Record (Bound Edition), Volume 153 (2007), Part 8]
[Senate]
[Pages 11362-11364]
[From the U.S. Government Publishing Office, www.gpo.gov]




                            DRUG IMPORTATION

  Mr. DORGAN. Mr. President, if and when we pass the underlying bill, 
we will have advanced this country's interests, I believe. But if we 
pass this bill by adding the Cochran amendment, which effectively kills 
the underlying amendment on which we have now voted cloture last 
Thursday, dealing with the safe importation of FDA-approved drugs at a 
much lower price--if we kill that by agreeing to the Cochran amendment, 
we will have substantially diminished the opportunity to provide for 
drug safety. That is a fact.
  The underlying bill doesn't have in it what we have in the Dorgan-
Snowe amendment, for which we have 33 cosponsors. We have pedigree 
requirements. We have serial requirements to be written on the pill 
bottles. We have anticounterfeiting measures. We have addressed all of 
those issues in the amendment. None of those requirements exist today, 
and none of those will exist with the domestic drug supply or with 
imported drugs when this legislation passes.
  The only way those provisions will exist is if we defeat the Cochran 
amendment and then pass the amendment that we have offered, allowing 
for the safe reimportation of prescription drugs, because we put the 
safety provisions in our amendment.
  Mr. President, let me ask unanimous consent to show once again two 
bottles of Lipitor.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DORGAN. This is a prescription drug made in Ireland. It is made 
in Ireland. It is called Lipitor. It is for the reduction of 
cholesterol. It lowers your cholesterol--the same pill, put in the same 
bottle, made by the same company, made in the same FDA-approved plant. 
It has only one difference--only one. That is, this one costs twice as 
much. Why? Because this one was sent to Canada and this was sent to the 
United States. The U.S. consumer is told: Congratulations, you get to 
pay twice as much for the prescription drug.
  But that is not unusual. It is happening all the time.
  Let's talk about counterfeiting. This is a $20 bill. This is a new 
$20 bill, you know, the ones we brag about, the ones the mint has press 
conferences about. We have all kinds of technology in this $20 bill to 
prevent and prohibit counterfeiters from reproducing this $20 bill.
  We can build a technology in a $20 bill to prevent counterfeiting, 
but we can't do it for medicine? Are you kidding me? What we have 
provided in this amendment is a series of steps: complete pedigree, 
serial numbers, RFID technology and anticounterfeiting measures. We can 
do it for a $20 bill but not for a bottle of medicine? Don't believe 
it.
  We are going to vote at 4 o'clock. The question is going to be: Will 
the pharmaceutical industry have their way once again, as they have so 
often?
  Let me make a point that is important. The Cochran amendment is 
already law. It was passed in 2003--in 2003. It already exists in law. 
The result is the Secretary of Health and Human Services says it can't 
be implemented because I can't certify there is no risk. The fact is 
the Secretary can't certify there is no risk with any new drug. He 
couldn't certify there is no risk with spinach coming from Mexico or 
strawberries coming from any other country. He couldn't certify there 
is no risk with any food product being imported. They can't certify 
there is no risk with the domestic drug supply. In fact, the domestic 
drug supply, without our amendment, will be dramatically less safe 
because you will not have the protections we put in this amendment.
  The pharmaceutical industry has never wanted them, and the underlying 
bill doesn't include them. It doesn't include the anticounterfeiting 
provisions. It doesn't include the pedigree, the serial requirement on 
the individual bottles to track back. It does not include that. That is 
a fact.
  So don't vote for the Cochran amendment and then tell people you want 
to allow Americans to import FDA-approved, lower priced drugs. The 
question is this: Should the American people be paying the highest 
prices in the world for prescription drugs? The answer is, no; it is 
not fair.
  Why should that be the case, that we should pay the highest prices in 
the world? So we have put together a piece of legislation--bipartisan, 
people on both sides of the aisle, 33 cosponsors. Then we are told, 
well, it is unsafe to do this. It is unsafe.
  That is nonsense. It is not unsafe. Europe has done it for 20 years. 
Europe can do it, but we can't do it? It gives consumers the 
opportunity to take advantage of the global marketplace.
  We are talking about FDA-approved drugs, made in FDA-approved plants, 
sold all over the world with one difference--price. The American 
consumers are told they have to pay the highest price. Dr. David 
Kessler is the expert on this, in my judgment. He was FDA Commissioner 
for 8 years, the head of the Food and Drug Administration. The Dorgan-
Snowe bill ``provides a sound framework for assuring that imported 
drugs are safe and effective.''
  Safe and effective. End of story, in my judgment. I understand the 
pharmaceutical industry does not want this. I understand that. They 
want to control prices. Yes, we have price controls in America, not 
Government price controls but price controls by the pharmaceutical 
industry.
  It is the only industrialized country in the world that I am aware of 
that says to the drug industry: Price it as you wish. It doesn't 
matter. You just price it as you wish.
  Well, what they have done--I had a hearing. Here is what they told 
me. They price at the level they price prescription drugs in this 
country because they can. Because they can. That might sound OK for the 
bottom line, but what does it mean for the person walking into the 
grocery store tonight in a small town in the Midwest who does not have 
much money and has to decide--the pharmacy is at the back of the 
store--I better go buy the prescription drugs the doctor says I need 
first to find out how much money I have left for groceries?
  It goes on all the time. Many of us believe, Republicans and 
Democrats, we ought to at least open the global marketplace for 
consumers to be able to pursue those FDA-approved drugs, made in FDA-
approved plants, at lower prices, the prices at which they are sold in 
virtually every other country in the world. This is unfair to the 
American consumer. That is the point.
  Interestingly, there was a long description of counterfeit drugs in 
the New York Times this weekend. None of that would be available to 
report, in my judgment, because it would not have happened if we had 
had the provisions, the safety provisions we have in the Dorgan-Snowe 
amendment.

[[Page 11363]]

  The fact is, you would not have danger in the drug supply because you 
would have much more money going to the FDA for the purpose of making 
certain the drug supply is safe. I am not just talking about the 
imported drugs, I am talking about a drug supply sold in this country, 
produced here and sold here. The lack of serial numbers, the lack of a 
pedigree, the lack of effective anticounterfeiting technology, the lack 
of resources to go after RFID technology, all of that is lacking in the 
underlying bill.
  It is not in the bill. The only way it is going to get there is if we 
are willing to defeat the Cochran amendment and to pass the amendment I 
have offered along with many of my colleagues. This is not a new issue. 
We have come to this issue on many occasions in the past. Each and 
every time the pharmaceutical industry has been able to trump us with 
votes on the floor of the Senate or the House. I hope--first I wish, 
second I hope, and finally I expect, that one of these days we will be 
able to prevail. One of these days we may be able to win this debate. 
Maybe it is today at 4 o'clock. I hope so.
  Some say, well, there will be no savings with your amendment. Well, 
the Congressional Budget Office says it is $50 billion in 10 years--$50 
billion. Is that a savings? It seems to me it is. Some say, well, this 
would be unsafe. You cannot prevent counterfeits from coming in.
  Once again, we have all of this technology to prevent somebody from 
counterfeiting a twenty-dollar bill, but we cannot with respect to 
medicine? Of course we can.
  Europe has done it for 20 years in a manner that is safe, but we 
cannot because we are not as smart as they are. Nonsense. Finally, at 
last, at long last, I hope this Senate will stand up to the 
pharmaceutical industry and say this: You are a good industry. We 
appreciate what you do. We like lifesavings drugs. But lifesavings 
drugs save no lives if you cannot afford to take them. We do not 
support your pricing policy. We believe a pricing policy that says to 
the American consumer: You pay the highest prices in the world, we 
believe that pricing policy is wrong and you have to change it. That is 
what I hope the message will be in this Chamber this afternoon.
  It is past the time, long past the time, in my judgment, for this 
Congress to stand up on these issues.
  In this case, let's stand up on the side of the American people who 
have been denied their right to participate in the global economy, to 
access a safe supply of drugs, FDA-approved, when it is sold in every 
other country for lower prices.
  Let me conclude by pointing out, as I did last week, an old man 
sitting on a straw bale on a North Dakota farm told me one day, he 
said: I am in my eighties. My wife has fought breast cancer for 3 
years. For 3 years we have driven to Canada to buy her Tamoxifen. Three 
years we have driven to Canada to buy the Tamoxifen.
  You can bring a small supply across the border if you do it 
personally. Why? Because it costs three-fourths less than it costs in 
the United States. He said: I save 80 percent by buying it in Canada. 
Yet for 3 years my wife has had to fight breast cancer and fight the 
high prices here, and we have had to drive into Canada.
  Well, the fact is, most Americans cannot drive to Canada. This bill 
is for most of the Americans who are paying prices that are too high. 
They want a safe drug supply, but they, for sure, finally, at long 
last, want a fair price, one they have not been getting, one they ought 
to get starting at 4 o'clock today.
  Mr. President, I yield the floor and reserve the remainder of my 
time.
  The PRESIDING OFFICER. The Senator from Vermont is recognized.
  Mr. SANDERS. Mr. President, let me congratulate the Senator for his 
outstanding leadership on this issue. Let me just pick up right from 
where he left off. He and I and Senator Snowe and a number of us have 
been dealing with this issue for many years. My involvement came in 
1999, when I took a busload of Vermonters, including many women who 
were struggling for their lives with breast cancer.
  Many of those women did not have a lot of money, and they also went 
across the Canadian border. They also purchased Tamoxifen. In those 
days, the price they paid was one-tenth the price, one-tenth the price 
compared to what they were paying in the United States. Here you have 
women struggling for their lives, who do not have a lot of money, and 
were paying one-tenth the price.
  This amendment is a big deal. This amendment will mean that Americans 
from one end of our country to the other, people with chronic 
illnesses, senior citizens who run into the doughnut hole, so-called 
doughnut hole on Medicare Part D, that finally these Americans, our 
Americans, our people, will no longer continue to be ripped off by the 
pharmaceutical industry and be forced to pay by far the highest prices 
in the industrialized world for the same exact medicine which people in 
Canada, people in Germany, people all over Europe receive at far lower 
prices--the same medicines, same companies, same factory, except we pay 
far higher prices.
  There is very strong support for this legislation. Millions of 
Americans are already supporting this legislation by getting into their 
cars and going over the Canadian border. The AARP and other senior 
organizations support this amendment. My understanding is that the AARP 
intends to note on their scorecard that a vote for the Cochran 
amendment--which is clearly a poison pill--is a vote against 
reimportation.
  I would urge my colleagues, if you disagree with reimportation, vote 
no. But a vote for the Cochran amendment is, in fact, a vote no.
  You have heard from Senator Snowe. You have heard from Senator 
Dorgan. The arguments over safety are just not accurate. This bill 
details in great length an entire regimen as to how we can make sure 
all of the prescription drugs reimported into the United States are 
safe and FDA approved.
  I always find it remarkable that every day, huge amounts of imported 
food are coming into this country. I do not hear a hue and cry about 
whether that food is inspected.
  Let me quote from the May 1st New York Times:

       More than 135 countries ship food items to the United 
     States. Canada, Mexico and China have led the way with China 
     shipping nearly five times as much in food items to the 
     United States as it did in 1996.

  China is importing more and more food into the United States. Where 
are the FDA inspectors? Are they all over the farms in China making 
sure these products are safe? I have not heard one word about that 
issue. This legislation has built in the strongest prescription drug 
safety regimen we have ever seen.
  Let me tell you what this debate is really about. It is not about 
prescription drug safety. It is about the power of the pharmaceutical 
industry, which in a city that has enormously powerful special 
interests, we have the pharmaceutical industry standing uniquely alone 
as the most important, if you will, and, in my view, greedy lobby in 
the entire United States of America. Here it is. Do you want to know 
what the issue is? Here it is: pharmaceutical industry lobbying.
  From 1998 to 2006 they spent $1.1 billion for lobbying; 1998 to 2006, 
$1.1 billion in lobbying.
  The pharmaceutical industry has over 1,000 well-paid lobbyists right 
here on Capitol Hill: former heads of the Republican Party, former 
leaders in the Democratic Party. Whenever anybody stands up for 
justice, whenever anybody stands up to try to lower the cost of 
prescription drugs in this country so that the American people can 
afford these lifesaving medicines, these lobbyists descend like locusts 
on all of our offices in the Senate, in the House. That is what they 
do.
  It is not just the amount of money they spend on lobbying. They spend 
a substantial amount of money on campaign contributions: From 1990 to 
2006, $139 million in campaign contributions; 2006 alone, $19 million. 
That is power. What this debate is about is not just the need to lower 
the cost of prescription drugs in America, as important as that is. 
What this debate is more significantly about is whether the Congress of 
the United States has the courage to stand up to the greediest, most

[[Page 11364]]

powerful special interests in this country.
  In November the American people went to the polls. They said they 
want a change in the direction in which this country is moving. 
Clearly, that election had a lot to do with Iraq. It certainly did. It 
had a lot to do with global warming, I believe. But it also, in any 
view, had a lot to do with the understanding that year after year 
wealthy and powerful special interests have dictated the terms of the 
debate, have paid for the legislation which has come through the Senate 
and through the House.
  The drug companies have managed to do something rather amazing. 
Virtually all of the Members of the Senate and the House look at 
economic issues through two lenses. No. 1, in order to protect 
consumers, we say: Let there be free market competition. That is the 
way to lower the costs of the product. And there is truth to that.
  The other way that we can protect consumers is through Government 
regulation. There is certainly truth to that. What the pharmaceutical 
industry has managed to do is tell us we cannot regulate the 
pharmaceutical companies. We cannot have Medicare negotiating lower 
prices with the drug companies. We cannot do that. They have given us 
all kinds of reasons we cannot do that.
  Then they have told us, well, we also cannot do free market 
competition: No, you cannot have the local druggist going out and 
purchasing the product at the best price that he can get, maybe in 
Canada, maybe Europe. You can't do that. You cannot have regulation. 
You cannot have free market competition.
  Then, on top of all of that, what the drug companies have managed to 
do is get many billions of dollars in corporate welfare, so the 
taxpayers of this country subsidize the research and development of 
many of the most important drugs, while the consumers, the American 
consumers, get no reasonable pricing despite the many billions of 
dollars that go into research and development that were paid for by 
them.
  The drug companies get it all. That is what they get. At the end of 
the day, year after year after year, they are one of the most 
profitable industries in this country. They are very profitable, and 
elderly people and working people all over this country find it harder 
and harder to pay for the prescription drugs they desperately need.
  Let us stand with the people. Let's defeat the Cochran amendment and 
pass the Dorgan amendment.

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